| NPI | 1851794622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NV 07787-L) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2024-08-07 |